The candidate is applying for a career development award in Cancer Prevention, Control and Population Sciences in order to investigate mammography screening for elderly women. During the period of the proposed award, the candidate will have a mentored experience in research using multiple methodologies: medical record review, focus groups, and surveys. Her course of training will include specific courses at the Harvard School of Public Health and the Harvard Graduate School of Education. She will continue her wort with leading experts in the fields of breast cancer screening and behavioral medicine to expand her experience in both qualitative and quantitative assessments of decision making regarding breast cancer screening by elderly women. The specific aims of this research proposal are to: 1. Describe factors associated with elderly women's use of mammography screening services. Two sub-aims are: A) Assess what factors, such as knowledge and attitudes about mammography, clinical co-morbidity, socioeconomic status, caregiving responsibilities, and psycho-social harms or benefits of mammography, are associated with screening mammography use among women over the age of 65 years; B) Investigate the psychological effects, both positive and negative, of mammography screening in the elderly. 2. Design a decision aid for elderly women for their use in considering whether to undergo screening. The aid will incorporate and reflect elements found to be important in determining whether screening is personally beneficial to individual women. The feasibility and acceptability of the decision aid will be assessed prospectively in a cohort of elderly women, and with a sample of their clinicians. This research will be conducted In the Department of Ambulatory Care and Prevention, a department of Harvard Medical School located in Harvard Pilgrim Health Care, a major teaching affiliate of Harvard Medical School. The candidate's research will have the support of regular ongoing mentoring by Suzanne Fletcher, Dennis Ross-Degnan and Karen Emmons. The educational resources of the Harvard School of Public Health and the Dana Farber Cancer Institute will provide needed support to the candidate's learning agenda and research. The completion of the work proposed in this application will supply the candidate with experience crucial to her growth as an academic researcher in cancer prevention, and will provide support for her development into an independent investigator in this field.